THE FACTS ABOUT GENDER AFFIRMING CARE

• Every credible medical organization calls for affirming care for transgender and non-binary people. Sexual orientation and gender identity are real concepts recognized by major medical and mental health associations — including the American Medical Association, the American Academy of Pediatrics, the American Psychological Association and the American Academy of Child and Adolescent Psychiatry — as part of the normal spectrum of human experience. Health care providers who work with transgender and non-binary people — including young people — are providing life-saving care, with many patients driving hundreds of miles just to get to their doctor’s office.

• Transgender children are not undergoing irreversible medical changes. This is a fundamental misunderstanding about what transition looks like for kids, which is primarily about providing social support, using the right name and pronouns, and allowing them to present in a way that is consistent with their gender identity. Therapists, parents and health care providers work together to determine which changes to make at a given time are in the best interest of the child.

• Transition-related, or gender-affirming care looks different for every transgender and non-binary person. Some transgender and non-binary people may only socially transition, such as using a new name and pronouns, and dressing in a way that is consistent with their gender identity. Others may socially and medically transition, including undergoing hormone therapy and/or gender affirmation surgery. Each person’s journey is unique to them and their medical needs. At the same time, many transgender and non-binary people cannot afford gender-affirming medical treatment, nor can they access it. Hormone therapy and surgical care are not offered to people, regardless of their age, without informed consent with the patient and, if they are a minor, with their parents/guardians.

• Not all transgender and non-binary people who transition have surgery. Some transgender and non-binary people transition without surgery. Some have no desire to pursue surgeries or medical intervention. Transgender children do not undergo gender-affirming surgeries, but may receive fully reversible medications that put puberty on hold under the care of a licensed medical provider. More permanent medical interventions do not occur until a transgender person is of age to give truly informed consent.

• Gender-affirming health care is lifesaving. For transgender people, being denied critically necessary transition-related care can extend and exacerbate the stress and discomfort caused by gender dysphoria, leading to increased incidences of depression and substance abuse, as well as health complications caused by delaying care. Ensuring that transgender and non-binary people have access to trans-affirming health care is lifesaving. A recent study from the Trevor Project provides data supporting this — transgender youth with access to gender-affirming hormone therapy have lower rates of depression and are at a lower risk for suicide. Another study, published in the Journal of the American Medical Association, found that transgender and non-binary youth who received gender-affirming care, including puberty blockers and gender-affirming hormones, saw a 60% reduction in depression and 73% reduction in suicidality over a 12-month follow-up. Additionally, multiple research studies have shown that parental and peer support, and affirmation of their gender identity and pronouns/names, is vital in ensuring transgender youth’s mental and physical health.

• Detransitioning is very rare. Medical regret is even rarer. Previous studies have found that de-transitioning is quite rare —with some studies finding levels of de-transition and regret as low as 1% or 2%. According to the National Center for Transgender Equality’s 2015 U.S. Transgender Survey, only 3% of respondents have detransitioned permanently at some point. Transgender youth who meet criteria for gender dysphoria and who undergo social or medical transition are actually the least likely to de-transition — and virtually all transgender youth remain consistent and persistent in their gender identity over time. . Detransitioning is often conflated with medical regret; however, detransitioning can include nonmedical parts of someone’s transition, such as changes in their gender expression or legal changes to their identity. And regret itself is low: a recent systematic review found that, across 27 peer-reviewed studies, the pooled prevalence of regret post-gender affirming surgery was 1% – in comparison, up to one-third of patients who have a knee replacement regret their procedure. Surgical regret could include trans patients who do not regret receiving surgery, but may be disappointed with one or more minor details relating to the outcome of their surgery. Trans people who also regret one or more parts of their surgery do not always detransition. When respondents detransition, it could include reasons beyond surgical regret. According to that same survey by the National Center for Transgender Equality, respondents who detransitioned cited a number of reasons for doing so, including facing too much harassment or discrimination after they began transitioning (31%), having trouble getting a job (29%), or pressure from a parent (36%), spouse (18%), or other family members (26%).

To read more about this, see our resource “Get the Facts on Gender Affirming Care” https://www.hrc.org/resources/get-the-facts-on-gender-affirming-care